容量超负荷状态对持续性非卧床腹膜透析患者血清白蛋白水平的影响

目的：探讨容量超负荷状态对持续性非卧床腹膜透析（CAPD）患者血清白蛋白（Alb）水平的影响。方法：对2009年6月在北京大学附属第三医院肾内科接受持续性非卧床腹膜透析患者进行横断面调查。采用BCM系统测定患者体成份,并以OH（overhydration）作为容量状态的评估指标;同时收集空腹血、24 h尿液及透析引流液用于透析充分性评估、Alb及其他生化检测。采用均数比较及多因素分析等统计学方法探讨容量状态与Alb之间的关系。结果：共有129例符合条件的患者入选本研究。根据总体Alb平均水平将患者分为两组,即Alb≥39 g/L和Alb〈39 g/L。结果显示前者OH及年龄平均水平均明显小于后者[OH,（1.75±1.60）vs（3.16±1.88）L,P〈0.05;年龄,（58.1±14.2）vs（67.8±12.3）岁,P〈0.05];多因素分析提示,在矫正性别、糖尿病后,OH与年龄是影响患者血清白蛋白水平的独立危险因素（R2=0.301,P〈0.05）。结论：本研究表明容量超负荷是影响腹膜透析患者低白蛋白血症发生的独立危险因素,并且OH也许是评估腹膜透析人群容量状况的良好指标。     

多频生物电阻抗法评估血液透析患者干体重

目的 应用多频生物电阻抗评估血液透析患者干体重.方法 选择81例维持性血液透析(Maintenance Hemodialysis,MHD)患者,采用人体成分分析仪,分别于透析前、后测定患者全身液体量(TBW,Total Body Water)、细胞外液(ECW,Extracellular Water)、细胞内液(ICW,Intracellular Water)、ECW与ICW之比E/I、容量超负荷(OH,Overhydration),并分别计算占体重的百分比(TBW％、ECW％和ICW％).结果 患者仅ICW透析前后无明显变化,透析后OH、TBW、TBW％、ECW、ECW％均较透析前明显下降,ICW％较透析前升高;透前TBW、ECW、ICW、TBW％、ECW％、ICW％和OH男性均高于女性,男性ECW/ICW比值低于女性.结论 MHD患者存在体液分布异常,主要表现为ECW％显著增加;血液透析脱水主要是除去多余的ECW,而对ICW无明显影响;多频生物电阻抗法可以对透析患者的容量状况提供客观依据.     

生物电阻抗法评估维持性血液透析患者的容量状态与高血压的关系

目的:通过采用多频生物电阻抗技术(MBIA)分析维持性血液透析(MHD)患者容量状态与血压之间的关系,为临床治疗提供参考。方法:收集2019年03月—2019年10月在我院血液透析室接受血液透析超过6个月的患者97例,记录患者一般信息、实验室指标、生物电阻抗测量干体重前后1周内的平均家庭自测血压等资料,采用MBIA测量患者透析前总体液(TBW)、细胞外液(ECW)和细胞内液(ICW)、身高标化后的细胞外液量(nECW),根据家庭血压情况分为高血压组及血压正常组,比较两组患者的血清学指标、体液分布情况;分析MHD患者高血压的危险因素。结果:(1)透析前,高血压组与血压正常组比较发现,高血压组在ECW/TBW、iPTH高于血压正常组,差异有统计学意义(P<0.05);(2)高血压组与正常血压组单因素分析结果显示：两组患者间ECW/TBW(P=0.032)、iPTH(P=0.049),差异有统计学意义(P<0.05);(3)高血压组与正常血压组多因素分析结果显示：透析前ECW/TBW(OR=1.146,95%CI 1.010～1.300,P=0.034)、iPTH(OR=1.00...     

新容量超负荷指标overhydration在腹膜透析患者中的临床价值

目的 评价overhydration（OH）作为新的容量超负荷无创指标在腹膜透析（腹透）患者中的应用价值。 方法 选择2009年1月至6月复诊于北京大学第三医院腹透中心的80例持续性非卧床腹透患者,应用生物电阻抗技术连续测定OH值6个月,在末次进行OH测定时,行超声心动图（UCG）检查。将OH值与UCG判断容量超负荷的心脏间接指标、长期容量超负荷状态下心脏结构改变的相关指标进行线性回归和相关分析。再按OH值将患者分为两组：OH＜2 L组（容量正常组）及OH≥2 L组（容量超负荷组）,比较两组间心脏形态结构、功能、血流动力学的差异。 结果 相关分析显示,80例腹透患者OH值与左室舒张末容积（EDV）、左室收缩末容积（ESV）、左室舒张末内径（LVEDD）、左房内径（LA）、左室质量（LVM）、体表面积标化左室质量指数（LVMIBSA）、身高标化LVMI（LVMI身高）均呈正相关（均P ＜ 0.01）,校正相关系数分别为0.21、0.27、0.14、0.12、0.26、0.25、0.20。两组间性别、年龄、身高、体质量、体质量指数（BMI）、尿素清除指数（Kt/V）差异均无统计学意义。OH≥2 L组OH、收缩压（SBP）、舒张压（DBP）、脉压（PP）、平均动脉压（MAP）均显著大于OH＜2 L组（均P ＜ 0.01）。两组间心脏收缩功能指标及舒张功能指标差异无统计学意义。OH≥2 L组的心脏结构形态指标和血流动力学指标均显著高于OH＜2 L组（P ＜ 0.01或P ＜ 0.05）。OH≥2 L组ESV高于OH＜2 L组,但差异无统计学意义（P = 0.08）。两组间总外周阻力（TPR）、总外周阻力指数（TPRI）差异无统计学意义。OH≥2 L组左室后壁舒张期厚度（LVPW）、室间隔舒张期厚度（IVS）、LVM、LVMIBSA、LVMI身高、左室肥厚（体表面积标化）（LVHBSA）和LVH身高均高于OH＜2 L组（P ＜ 0.01或P ＜ 0.05）。 结论 腹透患者OH与UCG指标显著相关,且OH值升高对心血管状况的影响与临床容量超负荷状态下的心脏形态、结构、血流动力学的改变相一致,因此,OH作为新的容量超负荷评价指标在腹透患者中有很好的应用价值。     

单次人体成分分析参数对住院尿毒症透析患者的预后价值

目的探讨生物电阻抗单次测定的营养及液体负荷指标对住院尿毒症患者预后的预测价值。 方法前瞻性连续纳入2014年1月至2016年12月在南京医科大学第一附属医院肾内科住院的成年维持性透析患者(包括血液透析、腹膜透析患者),患者入院后前3 d内均使用人体成分检测仪测定透析前人体成分。使用Kaplan-Meier法绘制生存曲线,使用Cox回归分析瘦体重指数(LTI)、脂肪组织指数(FTI)、细胞外液(ECW)与体细胞质量(BCM)比值(ECW/BCM)、过多水负荷(OH)与预后的关系,并进行多因素校正Cox回归分析。 结果(1)排除失访患者12例及随访期间行肾移植患者20例后共纳入819例患者,其中血液透析患者696例,腹膜透析患者123例。平均随访时间(28.1±9.7)月,172例(21%)患者随访期间死亡。(2)按照OH<-1L、-1～1 L及>1L将患者分为3组、按照OH/ECW比值将患者分为液体负荷过量(fluid overload)和液体平衡(fluid balance)两组、按照LTI、FTI、ECW/BCM的四分位数将患者各分为4组。生存分析发现不同OH组患者的死亡无显著差异(χ²＝ 2.4767,P＝0.2899),而不同体液状态的两组患者、不同LTI、FTI、ECW/BCM的4组患者的死亡有显著差异(体液状况2个组比较,χ²＝12.3874, P＝0.0004;LTI 4个组比较,χ²＝ 57.0897,P<0.0001;FTI 4个组比较,χ² ＝ 10.5650, P＝0.0143;ECW/BCM 4个组比较,χ²＝69.5081,P<0.0001)。其中,液体负荷组、LTI越低组,FTI越高组,ECW/BCM越高组,死亡风险趋向增高。多因素COX回归显示在校正透析龄、糖尿病、感染、舒张压、FTI、ECW/BCM后,高龄、高Charlson评分、低白蛋白、低LTI均是透析患者死亡的独立危险因素(HR_age＝1.03, P<0.001; HR_Charlson＝1.18, P＝0.003; HR_Alb＝0.94, P<0.001; HR_LTI＝0.84, P<0.001)。(3)按Alb和LTI的中位数将人群分为4组,发现预后按以下分组顺序依次变差：Alb>35.2、LTI>11.5组,Alb>35.2、LTI≤11.5组,Alb≤35.2、LTI>11.5组,Alb≤35.2、LTI≤11.5组。交互作用分析显示血Alb和LTI不存在交互作用。(4)亚组分析显示,血液透析亚组(n＝696)结果与总体类似,而腹膜透析亚组(n＝123)显示LTI、FTI与患者预后关系不明显。 结论低LTI、高FTI、高ECW/BCM、液体负荷过量与患者中期死亡显著相关,而单个点的OH与中期死亡无显著相关。即使在校正年龄、Charlson共病评分后,LTI仍独立于Alb与预后相关,且两者间无交互作用,提示LTI联合血清Alb可评价尿毒症患者的营养指标和判断预后。     

腹膜透析患者的总外周阻力对血压与容量关系的影响

目的 研究腹膜透析（PD）患者中高血压与正常血压患者容量状态发生重叠的血流动力学机制。 方法 选取51例PD患者，采用生物电阻抗方法评估患者的细胞外液（ECW）、细胞内液(ICW)、总体水(TBW)水平，并通过身高标化后得出NECW。根据不同性别组NECW的平均水平定义为正常容量状态组（NV组，NECW≤平均水平）及高容量状态组（HV组，NECW＞平均水平）。再根据容量和血压将患者分成4组：正常血压合并正常容量组 （NT-NV)、正常血压合并高容量组(NT-HV)、高血压合并正常容量组(HT-NV)和高血压合并高容量组(HT-HV)。超声心动图观测患者的每博输出量(SV)、心输出量(CO)及总外周阻力(TPR)，并以体表面积校正，计算出相对应的指数SI、CI和TPRI。 结果 高容量状态组的ECW、ICW、TBW均明显高于正常容量组。HT-NV 组TPR、TPRI 水平明显高于NT-HV组[分别为(219.4±47.4) 比(168.8±54.6) Pa&#8226;s&#8226;cm-3；(148.8±29.5)比(99.1±36.2) Pa&#8226;s&#8226;cm-1，均P < 0.01]，同时也显著高于其他2组（P < 0.05）。而NT-HV组SV、SI、CO及CI与NT-NV组、HT-NV组差异无统计学意义。但HT-NV组SV及CO明显低于HT-HV组[SV：(58.3±8.4) ml比(75.6±21.9) ml；CO：(4.03±0.70) ml/m2比(5.18±1.46) ml/m2；均P < 0.05]。 结论 PD患者中高血压与正常血压患者容量状况的重叠与TPR 及 TPRI的差异有关。正常血压合并高容量状态的患者存在低TPR和TPRI，而高血压合并正常容量状态的患者则存在高TPR和TPRI。     

生物电阻抗矢量法评估血液透析合并高血压患者的容量负荷

目的应用生物电阻抗矢量法评估血液透析合并高血压患者的容量负荷,探讨高容量负荷状态对高血压患者预后的影响。方法研究对象来自南京医科大学附属明基医院透析前收缩压(6次透析治疗前平均收缩压值)>160 mmHg的血液透析患者。用生物电阻抗矢量法评估患者容量状态,并根据患者容量状态分为容量增加组和非容量增加组(包括容量正常和容量下降的患者)。比较两组患者临床资料、实验室指标、细胞内液比例(ICW)、细胞外液比例(ECW)、体细胞质量、瘦体重、干瘦体重及其占总体重的百分比、脂肪含量占总体重的百分比、阻抗/身高、容抗/身高、相位角、疾病指数的差异。采用Kaplan⁃Meier生存曲线比较两组患者生存率的差异。结果共51例血液透析合并高血压患者入选本研究,容量增加组19例,非容量增加组32例(容量正常27例,容量下降5例)。容量增加组患者的血白蛋白、前白蛋白、血红蛋白、血细胞比容、血磷较非容量增加组显著下降,淋巴细胞比例明显升高,组间比较差异均有统计学意义(均P<0.05)。容量增加组的细胞外液比例、疾病指数显著高于非容量增加组(均P<0.01);相位角、阻抗/身高、容抗/身高显著低于非容量增加组(均P<0.01)。临床追踪20个月,容量增加组患者血压达标率(透析前收缩压<160 mmHg)低于非容量增加组(26.3%比43.8%),但差异无统计学意义。容量增加组患者全因死亡率高于非容量增加组(26.3%比15.6%),Kaplan⁃Meier生存曲线分析提示两组生存率的差异尚无统计学意义。结论容量负荷增加的血液透析合并高血压患者细胞外液增加明显,营养状态评估指标较非容量增加的高血压患者明显下降,而淋巴细胞比例升高,可能与患者微炎症状态有关。容量负荷增加的高血压患者血压更加难以控制,临床预后可能不及非容量增加的患者。     

持续性非卧床腹膜透析患者容量超负荷与大动脉僵硬度的关系

目的探讨持续性非卧床腹膜透析（CAPD）患者细胞外液（ECW）与总体水（TBW）的比率（E／T）与脉搏波速度（PWV）的关系。方法选取56例CAPD患者为研究对象。自动PWV分析仪测定PWV。多频生物电阻抗分析仪对患者的容量状态进行评估。对相应指标进行相关及多元回归分析，筛选出PWV的影响因素。结果结果显示E／T（β=0．472．P=0．001）、脉压（β=0．442，P=0．001）、C反应蛋白（β=0．246，P=0．05）是PWV增加的独立危险因素。3者一起决定了PWV变化的58．1％，其中E／T决定37．8％。结论在透析患者中容量超负荷可能是通过动脉硬化程度的加重导致心血管疾病发生率和病死率增加的。     

腹膜透析治疗对微炎症状态的影响

目的：比较腹膜透析患者接受透析治疗前和透析治疗后血液中微炎症状态指标的差别,同时比较腹膜透析后血液中与透析出超液中微炎症状态指标的差别,观察腹膜透析治疗微炎症状态存在的情况。方法：选择我院透析中心腹膜透析患者43例,在接受透析治疗前和透析治疗后分别空腹采取透析静脉血,同时留取4h出超液,检测超敏CRP（hs-CRP）、IL-6、IL-8、TNF-α,进行统计学分析。结果：腹膜透析治疗前微炎症因子hs-CRP、前炎症细胞因子IL-6、IL-8水平高于腹膜透析治疗后,P〈0.05;前炎症细胞因子TNF-α两者比较无统计学差异（P〉0.05）。腹膜透析患者出超液中微炎症因子hs-CRP、前炎症细胞因子IL-8、TNF-α水平低于腹膜透析血液组,P〈0.05;出超液中前炎症细胞因子IL-6水平高于腹膜透析血液组,P〈0.05。结论：慢性肾病尿毒症患者经腹膜透析治疗后微炎症状态有所改善,这一改善是通过毒素的清除,尿毒症症状的改善而得以改善的,透析治疗不能直接清除微炎症因子。     

维持性透析患者透析后血压变异的危险因素研究

目的:探讨维持性透析(MHD)患者透析后6 h内血压变异增加的危险因素。方法:选择稳定透析患者123例,根据患者透析后6 h的血压的变异度(BPV)分为收缩压高变异组(HSBPV)及收缩压低变异组(LSBPV)、舒张压高变异组(HDBPV)及舒张压低变异组(LDBPV),分析患者血压变异度的影响因素。结果:透析后6 h患者SBPV为(12.56±2.38)%、DBPV为(12.60±3.04)%。在高收缩压变异组与低收缩压变异两组的年龄、干体重、单次透析超滤量、细胞外液(ECW)、细胞内液(ICW)、血红蛋白、i PTH、TC差异有统计学意义(P0.05),高舒张压变异组与低舒张压变异两组的年龄、干体重、单次透析超滤量、ECW、ICW、血红蛋白、i PTH、TC差异有统计学意义(P0.05)。干体重、ECW、血红蛋白、i PTH、TC是MHD患者透析后收缩压变异度的独立危险因素(P0.05),年龄、TC是MHD患者透析后舒张压变异度的独立危险因素(P0.05)。结论:透析前细胞外液高容量、低血红蛋白血症、高胆固醇血症、炎症状态及未得到控制的继发性甲旁亢可增加MHD患者透析后6 h的收缩压变异度;高龄、高胆固醇血症可增加MHD患者透析后8 h的舒张压的变异度。     

Effect of icodextrin on volume status,blood pressure and echocardiographic parameters: a randomized study

Overhydration is a risk factor for hypertension and left ventricular hypertrophy in peritoneal dialysis patients. Recently, a high prevalence of subclinical overhydration was observed in peritoneal dialysis patients. Aim of the present open-label randomized study was to assess the effect of a icodextrin 7.5% solution on fluid status [extracellular water (ECW) bromide dilution], blood pressure regulation (24-hour ambulatory measurements) and echocardiographic parameters during a study period of 4 months, and to relate the effect to peritoneal membrane characteristics (dialysate/plasma creatinine ratio). Forty peritoneal dialysis patients (22 treated with icodextrin, 18 controls) were randomized to either treatment with icodextrin during the long dwell or standard glucose solutions. Thirty-two patients (19 treated with icodextrin, 13 controls] completed the study. The use of icodextrin resulted in a significant increase in daily ultrafiltration volume (744 +/- 767 mL vs. 1670 +/- 1038 mL; P = 0.012) and a decrease in ECW (17.5 +/- 5.2 L vs. 15.8 +/- 3.8 L; P = 0.035). Also the change in ECW between controls and patients treated with icodextrin was significant (-1.7 +/- 3.3 L vs. +0.9 +/- 2.2 L; P = 0.013). The effect of icodextrin on ECW was not related to peritoneal membrane characteristics, but significantly related to the fluid state of the patients (ECW:height) (r = -0.72; P < 0.0001). Left ventricular mass (LVM) decreased significantly in the icodextrin-treated group (241 +/- 53 grams vs. 228 +/- 42 grams; P = 0.03), but not in the control group. In this randomized open-label study, the use of icodextrin resulted in a significant reduction in ECW and LVM. The effect of icodextrin on ECW was not related to peritoneal membrane characteristics, but was related to the initial fluid state of the patient.     

Predictors of a favourable response to icodextrin in peritoneal dialysis patients with ultrafiltration failure

BACKGROUND AND AIMS: Icodextrin is a starch-derived glucose polymer that causes sustained ultrafiltration in long dwells in peritoneal dialysis. The aim of this study was to assess factors that were predictive of an increment in ultrafiltration following the introduction of icodextrin in patients with refractory fluid overload. METHODS: Thirty-nine patients (20 male/19 female, mean age 57.7 +/- 2.4 years) on peritoneal dialysis were enrolled in a prospective pretest/post-test, open-label study. All patients had symptomatic fluid overload refractory to fluid restriction (<800 mL/day), frusemide doses of 250 mg or more daily, optimization of dwell time and use of hypertonic dextrose. An icodextrin exchange was substituted for a 4.25% dextrose exchange for the long-dwell period. RESULTS: After 1 month, median (interquartile range) 24 h ultrafiltration volume increased by 500 mL (interquartile range: 50-1000). An increase in ultrafiltration volume correlated positively with the dialyate : plasma creatinine ratio at 4 h (r = 0.498, P = 0.001) and negatively with the ratio of dialysate glucose concentrations at 4 and 0 h (r = -0.464, P = 0.003). On multivariate regression analysis, high transporter status was predictive of a greater ultrafiltration response to icodextrin relative to dextrose peritoneal dialysis exchanges. Age, sex, race, peritoneal dialysis duration, peritoneal dialysis modality, diabetes mellitus, baseline albumin, and baseline ultrafiltration volume were not significantly correlated with the change in ultrafiltration volume. CONCLUSION: Icodextrin significantly augments ultrafiltration volumes in patients with refractory fluid overload. A high peritoneal membrane transporter status is the best predictor of a favourable ultrafiltration response to icodextrin.     

Body composition measurements using bioimpedance analysis in peritoneal dialysis patients are affected by the presence of dialysate

The presence of peritoneal dialysate when performing bioimpedance analysis may affect body composition measurements. The aim of this study was to evaluate the impact of dialysate on body composition measurements in Asians. Forty‐one patients undergoing maintenance peritoneal dialysis in our hospital peritoneal dialysis unit were included in this study. Dialysate was drained from the abdomen prior to measurement, and bioimpedance analysis was performed using multi‐frequency bioimpedance analysis, with each subject in a standing position (D‐). Dialysate was then administered and the measurement was repeated (D+). The presence of peritoneal dialysate led to an increase in intracellular water (ICW), extracellular water (ECW), and total body water (D‐: 20.33 ± 3.72 L for ICW and 13.53 ± 2.54 L for ECW; D+: 20.96 ± 3.78 L for ICW and 14.10 ± 2.59 L for ECW; P < 0.001 for both variables). Total and trunk oedema indices were higher in the presence of peritoneal dialysate. In addition, the presence of peritoneal dialysate led to an overestimation of mineral content and free fat mass (FFM) for the total body; but led to an underestimation of body fat (D‐: 45.80 ± 8.26 kg for FFM and 19.30 ± 6.27 kg for body fat; D+: 47.51 ± 8.38 kg for FFM and 17.59 ± 6.47 kg for body fat; P < 0.001 for both variables). Our results demonstrate that the presence of peritoneal dialysate leads to an overestimation of FFM and an underestimation of fat mass. An empty abdomen is recommended when evaluating body composition using bioimpedance analysis.     

Diameter of inferior caval vein and impedance analysis for assessment of hydration status in peritoneal dialysis

In 19 stable peritoneal dialysis (PD) patients, hydration status was evaluated by measurement of vena cava diameter (VCD) and bioelectrical impedance analysis (BIA) variables: intracellular water (ICW), extracellular water (ECW), and total body water (TBW). We investigated whether BIA can replace VCD. VCD did not correlate with TBW but correlated moderately with ECW/TBW (r = 0.42; 0.025 < p < 0.05) and ICW/ECW (r = -0.47; p < 0.025). Patients with underhydration (n = 4; VCD <8 mm/m2) revealed limits for BIA variables as ICW/ECW (>1.50) and ECW/TBW (<0.40). The same held true for overhydration (n = 5; VCD >11.5 mm/m2): ICW/ECW (<1.50) and ECW/TBW (>0.40). Although the positive predictive value of ICW/ECW and ECW/TBW for both under- and overhydration was only 50% and 54%, respectively, there were no false negative values. Although BIA cannot replace VCD in PD patients, the reverse holds true as well. Combining BIA and VCD may lead to a better estimation of hydration status because both techniques provide complementary information.     

Influence of peritoneal dialysis solution on measurements of fluid status by bioimpedance spectroscopy

Purpose and methods

The accurate estimation of volume status is a central problem in dialysis patients. Recently, a bioimpedance spectroscopy (BIS) device (BCM Body Composition Monitor FMC, Germany) has attained growing interest in this regard. By processing the raw data for extracellular water (ECW) and intracellular water (ICW) by means of a validated body composition model, this device allows a quantification of the individual fluid overload (FO) compared to a representative healthy population. In this study, we addressed the issue whether the presence of peritoneal dialysate has an impact on measurements of FO by BIS in PD patients.

Results

Forty-two BIS measurements using the BCM device were performed both in the absence (D?) and presence (D+) of peritoneal dialysate in 17 stable PD patients. Data for ECW, ICW and FO (D+; D?) were analyzed by paired t test and linear regression. Mean FO was 0.99 ± 1.17 L in D? and 0.94 ± 1.27 in D+ (p = n.s. paired t test). Linear regression demonstrated an excellent degree of conformity between FO (D?) and FO (D+) (r ² = 0.93).

Conclusion

The presence of peritoneal fluid in PD patients has a negligible influence on measurements of FO by BIS. The BIS measurements can be therefore conveniently and reliably done without emptying the peritoneal cavity; this may facilitate the use of BIS in this particular group of patients.     

Extracellular volume expansion and the preservation of residual renal function in Korean peritoneal dialysis patients: a long-term follow up study

Introduction

In chronic peritoneal dialysis patients, preservation of residual renal function (RRF) is a major determinant of patient survival, and maintaining sufficient intravascular volume has been hypothesized to be beneficial for the preservation of RRF. The present study aimed to test this hypothesis using multifrequency bioimpedence analyzer (MFBIA), in Korean peritoneal dialysis patients.

Methods

A total of 129 patients were enrolled in this study. The baseline MFBIA was checked, and the patients were divided into the following two groups: group 1, extracellular water per total body water (ECW/TBW) < median, group 2, ECW/TBW > median. We followed up the patients, and then we analyzed the changes in the urine output (UO) and the solute clearance (weekly uKt/V) in each group. Data associated with patient and technical survivor were collected by medical chart review. The volume measurement was made using Inbody S20 equipment (Biospace, Seoul, Korea). We excluded the anuric patients at baseline.

Result

The median value of ECW/TBW was 0.396. The mean patient age was 49.74 ± 10.01 years, and 62.1 % of the patients were male; most of the patients were on continuous ambulatory peritoneal dialysis (89.1 %). The mean dialysis vintage was 26.20 ± 28.71 months. All of the patients were prescribed hypertensive medication, and 48.5 % of the patients had diabetes. After 25.47 ± 6.86 months of follow up, ΔUO and Δweekly Kt/V were not significantly different in the two groups as follows: ΔUO (?236.07 ± 185.15 in group 1 vs ?212.21 ± 381.14 in group 2, p = 0.756); Δ weekly Kt/v (?0.23 ± 0.43 in group 1 vs ?0.29 ± 0.49 in group 2, p = 0.461). The patient and technical survivor rate was inferior in the group 2, and in the multivariable analysis, initial hypervolemia was an independent factor that predicts both of the patient mortality [HR 1.001 (1.001–1.086), p = 0.047] and the technical failure [HR 1.024 (1.001–1.048), p = 0.042].

Conclusions

Extracellular volume expansion, measured by MFBIA, does not help preserve residual renal function, and is harmful for the technical and patient survival in Korean peritoneal dialysis patients.